Gold hospital cover in Australia is shrinking while its price climbs, according to HCF figures reported by Insurance Business on 19 October: gold made up 28% of hospital cover last year, against 40% in 2019, and the average gold premium rose 71% over that period. HCF chief executive Lorraine Thomas said mental health admissions account for 90% of the claims on the fund's gold-tier products. HCF has about 2.1 million members.
The fund's white paper projects that 1.2 million Australians could leave gold cover over the next ten years unless the way conditions such as depression, bipolar disorder and addiction are treated and funded changes. Funds must apply for their 2027 premium changes in November, and a government consultation on private health reforms closed in August. Bupa has separately asked for the Private Health Insurance Act to be changed so that funds can pay for community mental health care.
HCF's cost data, as presented in the report, put private funds' hospital mental health benefits at about A$749m in 2024-25, around 4% of all benefits. The average overnight benefit rose about 24%, from A$12,515 to A$15,541, and HCF says acute stays now average 19 days and are still lengthening. A major affective disorder admission averaged A$23,774 in benefits in 2025, close to the A$24,157 for a knee replacement.
Other signs of strain appear in the report. Some rival funds have stopped selling gold products, and consumer group CHOICE found rises of up to 25% on some gold products in April. In life insurance, the Council of Australian Life Insurers says mental health claim payments passed A$2.2bn in 2024, nearly double the level of five years earlier.
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Insurance Business (Australia) ↗News publisher · 19 Oct 2026
This is an original brief based on the linked publication. Company statements and forecasts are attributed to their source.
